DESCRIPTION: (Applicant's Abstract) This project proposes to examine how chronic drug abusers, previously incarcerated and returning to the community, utilize health services including drug abuse treatment, health care, and mental health care services as well as their costs. The goal of this study is to provide information that can be used to improve health services delivery for chronic drug abusers. These data will be important for planning, developing, and providing health services and interventions for chronic drug abusers, particularly in rural areas because the literature is largely focused on urban areas. Over the Project's five years, a sample of incarcerated male (n=250) and female (n=60) chronic drug abusers voluntarily entering treatment for their drug abuse and completing it, a sample of male (n=250) and female (n=60) chronic drug abusers not completing treatment, and a comparison group of male (n=250) and female (n=60) chronic drug abusers not receiving treatment will be recruited and followed. The specific aims for this project are to (1) develop a health services use profile of chronic drug abusers with baseline and longitudinal data in a predominantly white, rural and urban sample to describe how drug abuse treatment, mental health care and other health care needs are met; (2) Describe drug abuse treatment, mental health care, and other health care service utilization experiences of chronic drug abusers using Life History Analysis of drug use, major illness, health service utilization, lifestyle characteristics, and criminal justice encounters; (3) Provide a description of relationships between drug abuse treatment, mental health treatment, and other health service utilization with subsequent community health services utilization, relapse-recidivism, criminal justice encounters, and other life changes; (4) Estimate drug abuse treatment costs and other mental and health care service costs and assess the relationship between the costs of these services and the cost (real and avoided) of subsequent health care, public assistance, and criminal justice interventions; and (5) Identify barriers and facilitating factors for chronic drug abusers in accessing treatment, mental health services and other health care services.